Provider Demographics
NPI:1265280549
Name:PAGE-HIGHTOWER, MICHELLE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:PAGE-HIGHTOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5779 AMES RD APT 7D
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6262
Mailing Address - Country:US
Mailing Address - Phone:706-550-4998
Mailing Address - Fax:
Practice Address - Street 1:5779 AMES RD APT 7D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6262
Practice Address - Country:US
Practice Address - Phone:706-550-4998
Practice Address - Fax:803-889-5111
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor